Target-controlled inhalation anaesthesia: A cost-benefit analysis based on the cost per minute of anaesthesia by inhalation

Ponsonnard, S.; Galy, A.; Cros, Jérôme; Daragon, A; Nathan, Nathalie

doi:10.1016/j.accpm.2016.02.005

Cited by 4 publications

(4 citation statements)

References 19 publications

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“…Manufacturers of anesthesia machines have been trying to decrease the cost of modern inhalational agents like desflurane and sevoflurane. The use of low flow during sevoflurane anesthesia has been considered as a way to decrease the anesthesia related expenditure [7,8]. Although a small number of studies investigated EtSev as a target for maintenance of inhalational anesthesia, this mode is offered as a promoted eco-nomic delivery technique in which gas flow and vaporizer output are modified to reach the chosen end-tidal concentration [4,5,9,17].…”

Section: Discussionmentioning

confidence: 99%

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Automated control of end-tidal sevoflurane in living donor hepatectomy, a prospective, randomized, controlled study

Kandeel

Elmorshedi

Abdalla

et al. 2017

Egyptian Journal of Anaesthesia

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Background: Reduction of anesthesia cost has become a necessity, especially in developing countries. Recently, automated control of end-tidal sevoflurane concentration (EtSev) has been proposed as a new technique with both cost-effectiveness and safety profiles. In this study, sevoflurane consumption (primary outcome variable) was evaluated during living donor hepatectomy using automated control of EtSev (EtC) at fresh gas flow (FGF) of 0.5 and 2 L/min compared to manual control (MC) technique at FGF of 2 L/min. Materials and methods: Prospective, randomized, controlled trial including 60 Potential donors scheduled for living donor right hepatectomy. patients were randomized into 3 equal groups (according to target control of sevoflurane), MC group, EtC-2L group, and EtC-0.5L group. In MC group: FGF was set to 2 L/ min, inspired concentration of Sevoflurane (FiSev) was set to 1.5-2% in 0.4 fractional inspired oxygen concentration (FiO2), while in EtC-2L group: FGF was set to 2 L/min, EtSev was set to 1-1.5% with end tidal oxygen concentration (EtO2) target of 0.35. In EtC-0.5L group, FGF was set to minimal flow and EtSev target to 1-1.5% and EtO2 target of 0.35. Anesthetic gases consumption (sevoflurane ml, Oxygen L, and air consumption L) per anesthesia hour were recorded at the end of surgery. Other recorded data included intraoperative hemodynamics, the number of user adjustments, and extubation time. Results: Significant reduction in sevoflurane consumption when EtC-0.5L is used (4.2 ± 1.3 ml/h, 12.6 ± 2.6 ml/h, and 15 ± 2.9 ml/h respectively, p. 0.001). Also, a significant decrease in overall numbers of user adjustments between the three groups (8 times for EtC-0.5L group, 7 times in EtC-2L group, 22 times for MC group, p. 0.008) was observed. Conclusion: automated control of EtSev during anesthesia of living donor hepatectomy significantly lowers sevoflurane consumption and decreases required user interventions without deleterious effect on patient safety.

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Section: Discussionmentioning

confidence: 99%

“…Most of the studies that investigated EtC were conducted for relatively short period surgeries and non-homogenous patients [6,[8][9][10][11][12]. In our study, we applied EtC mode (Aisys CS2 anesthesia delivery systems, USA) during living donor right hepatectomy where the average anesthetic duration is around 6 h [7,13].…”

Section: Introductionmentioning

confidence: 99%

Automated control of end-tidal sevoflurane in living donor hepatectomy, a prospective, randomized, controlled study

Kandeel

Elmorshedi

Abdalla

et al. 2017

Egyptian Journal of Anaesthesia

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“… 1 , 2 , 3 Cost analyses provide decision-makers with relevant information about resource consumption and trade-off between costs and outcomes associated with different health technologies. 4 The results of such analyses aim to reach rational approaches to introduce novel health technologies, particularly in rapidly evolving medical fields such as anesthesiology. 4 In fact, anesthesiology is a medical field that has been characterized by relevant technologic advances, thus allowing safe pain management 5 , 6 and enabling the implementation of innovative cost-effective treatment approaches.…”

Section: Introductionmentioning

confidence: 99%

“… 4 The results of such analyses aim to reach rational approaches to introduce novel health technologies, particularly in rapidly evolving medical fields such as anesthesiology. 4 In fact, anesthesiology is a medical field that has been characterized by relevant technologic advances, thus allowing safe pain management 5 , 6 and enabling the implementation of innovative cost-effective treatment approaches. 7 , 8 , 9 …”

Section: Introductionmentioning

confidence: 99%

Identification and economic burden of main adverse events of nerve injuries caused by regional anesthesia: a systematic review

Calciolari

González-Ortiz

Mongelli

et al. 2023

Brazilian Journal of Anesthesiology (English Edition)

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The end of desflurane. Comment on Br J Anaesth 2022; 129: e81–2

Ponsonnard

2024

British Journal of Anaesthesia

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Target-controlled inhalation anaesthesia: A cost-benefit analysis based on the cost per minute of anaesthesia by inhalation

Cited by 4 publications

References 19 publications

Automated control of end-tidal sevoflurane in living donor hepatectomy, a prospective, randomized, controlled study

Automated control of end-tidal sevoflurane in living donor hepatectomy, a prospective, randomized, controlled study

Identification and economic burden of main adverse events of nerve injuries caused by regional anesthesia: a systematic review

The end of desflurane. Comment on Br J Anaesth 2022; 129: e81–2

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